Cisplatin, vinblastine, and bleomycin in advanced and recurrent ovarian germ-cell tumors: a trial of the Gynecologic Oncology Group

Article Abstract:

Combination chemotherapy containing cisplatin has substantially improved the outcome for male patients with early and advanced germ-cell tumors. On the basis of this success, this regimen was tried on female patients, with reported success. Further study was conducted by the Gynecologic Oncology Group, testing the combination therapy of cisplatin, vinblastine and bleomycin (PVB) in 97 patients with advanced ovarian germ-cell tumors. Surgical removal and chemotherapy were also assessed. The two year disease-free rate was 51 percent and the overall two-year survival was 71 percent. Forty-three percent (15 out of 35) of the patients with tumors other than dysgerminomas, tumors confined to one ovary, had complete responses after three to four courses with PVB. Seven out of eight patients with dysgerminomas had complete responses. This study did not show any no clear value to surgically debulking the tumor, nor of second-look laparotomy or exploratory surgery. Residual cancer was seen by second-look laparotomy in 28 percent of the patients who were clinically disease-free. It is not certain if the early diagnosis of residual tumor will lead to better treatment. The treatment of patients with dysgerminoma by chemotherapy is controversial. It is felt that these tumors should treated by surgical removal of the ovary and postoperative radiotherapy. However, patients who are treated with this regimen will be infertile, while treatment of dysgerminomas with cisplatin retains fertility. This study has shown that treatment of ovarian germ-line tumors with cisplatin-based chemotherapy is effective and is superior to other regimens. (Consumer Summary produced by Reliance Medical Information, Inc.)

Germ cell tumors, Germinoma, Ovarian tumors, Bleomycin, Vinblastine

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Continuous infusion high-dose leucovorin with 5-fluorouracil and cisplatin for untreated stage IV carcinoma of the head and neck

Article Abstract:

The effects of the anticancer agents cisplatin, 5-fluorouracil, and high-dose leucovorin (PFL) in treating advanced squamous cell carcinoma of the head and neck was assessed. Squamous cells are a flat, scaly type of epithelial cell which line the outer surface of the body, body cavities and passages leading to the exterior. The study included 35 cancer patients; four patients had stage III and 31 had stage IV cancer. The drugs were administered directly into the circulation once every 28 days. The effectiveness of drug therapy was assessed by biopsy or surgical removal of the tumor. PFL was effective in 28 of 35 patients, producing a partial response in 5 patients and a complete response in 23 patients. A complete response was confirmed by tumor sampling (biopsy) in 14 of 19 patients. The most common adverse effect of therapy was mucositis, or inflammation of the mucous membranes. The doses of the drugs were reduced due to toxic effects in 11 patients. The results suggest that cisplatin, 5-fluorouracil, and high-dose leucovorin are an effective anticancer regimen for treating advanced squamous cell carcinoma of the head and neck. (Consumer Summary produced by Reliance Medical Information, Inc.)

Squamous cell carcinoma, Fluorouracil, Leucovorin, Folinic acid

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Chemotherapeutic failure: resistance or insensitivity?

Article Abstract:

Research on chemotherapy and immunotherapy should be continued but cut back, and promising molecular biology techniques should be pursued further. While chemotherapy has been useful in treating some cancers - lymphomas and some acute leukemias - it cannot cure most cancers. Many attribute chemotherapy's ineffectiveness to the high rate of cancer cell mutations and the selection of drug insensitive cells. However, more recent studies suggest most cancer cells are simply insensitive to antiproliferative drugs. Immunotherapy, too, is non-specific and has demonstrated limited efficacy. Molecular research on cancer cells, however, has already discovered mutations that are specific for tumor proteins. Other studies have discovered deletions of specific tumor suppressor genes in patients with a family history of cancer. These preliminary findings should be incorporated into cancer treatment efforts.

Usage, Cancer treatment, Molecular biology, Immunotherapy

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